Background: Asymptomatic bacteriuria (ASB) is a relatively common condition occurring due to the morphological and physiological changes in the genitourinary tract during pregnancy. If left untreated, it may lead to acute pyelonephritis and adverse fetal and maternal outcomes. The objective was to determine prevalence, risk factors and etiological agents with susceptibility for ASB among pregnant women attending an antenatal clinic at a tertiary care hospital, Odisha, India.Methods: A prospective study with 200 pregnant women was conducted, over a period of 4 months, starting from 1st April 2017 to 31st July 2017. The mid- stream clean catch urine specimen was collected and processed in all the cases and other data were collected from the questionnaire given to them. The isolates from all the cases of ASB were identified and antimicrobial susceptibility was tested by Kirby- Bauer disc diffusion method and interpreted.Results: Prevalence of ASB in our study was 25.3%, with maximum prevalence among age group 21-30 yrs, during 3rd trimester, among multigravidae. Previous history of urinary tract infection (UTI), anaemia and diabetes have significant association with ASB. Klebsiella spp. was the predominant isolate in this study followed by Escherichia coli. Nitrofurantoin and Cefixime are safe and effective antibiotics against urinary pathogens in pregnancy.Conclusions: Undiagnosed and untreated asymptomatic bacteriuria is associated with complications during pregnancy. Hence routine screening of antenatal women for ASB during all trimesters must be considered for preventing the adverse maternal and foetal outcomes particularly with known risk factors like increasing age, multiparity and previous history of UTI.
Background: Fetal surveillance even in normal or low risk pregnancy is essential to ensure safe parturition with minimum intervention. Cardiotocography (CTG) and clinical estimation of amniotic fluid volume (AFV) measured as amniotic fluid index (AFI) are two tests that are easily available in the labor room and can be used to identify fetal well-being. Our study aimed to evaluate role of admission cardiotocography (CTG) and amniotic fluid index (AFI) on perinatal outcome in low risk pregnancy at term.Methods: The study was conducted as a prospective observational study. All low risk pregnant women at term admitted to the labor ward in early or established labour between September 2018 and August 2020 were included in the study. They underwent admission CTG and AFI assessment using ultrasonography. All parameters including CTG changes, mode of delivery, AFI, presence of meconium, APGAR score at 1 and 5 mins, need for admission in neonatal ICU and perinatal mortality were recorded. Quantitative data was compared using chi square test.Results: A total of 180 patients were included in the study. Majority of the women belonged to the age group of 30-35 years. Abnormal CTG showing fetal distress was seen in 105 (58.33%) cases. Non-reactive CTG was significantly associated with meconium stained liqour, requirement for LSCS, still birth, fetal distress, APGAR <7 at 1 and 5min and NICU admission (p<0.001). The association of low AFI with non-reactive CTG had statistically significant impact on perinatal outcomes like low birth weight, requirement for LSCS, fetal distress, APGAR <7 at 1 and 5 mins and NICU admissions.Conclusions: Admission CTG is a simple non-invasive test that can serve as a screening tool in low risk obstetric population to detect fetal distress already present or likely to develop and prevent unnecessary delay in intervention. Thus, it may help in preventing fetal morbidity and mortality.
Background: The incidence of obesity has increased to pandemic proportions over the last 20 years. Maternal obesity is associated with a wide array of adverse maternal pregnancy outcomes and increased risks in the offspring. The aim of the study was to find the effect of obesity on maternal and perinatal outcome in obese women in comparison to those of normal weight women.Methods: The study was designed as a case-control study. Antenatal women with first trimester body mass index (BMI) of more than 30 kg/m2 constituted the cases and those with BMI between 18 and 24.9 kg/m2 formed the controls.Results: There was increased incidence of antepartum complications in obese women. Obese women had a significant history of prior treatment for infertility (p<0.00001). The incidence of gestational diabetes (OR 4.76, 95%CI 1.267-17.72 p=0.014), gestational hypertension (OR 3.05, 95%CI 1.01-9.20 p=0.04), induction of labor (OR 2.5, 95%CI 1.0-6.28 p=0.04), preeclampsia (OR 2.38, 95%CI 1.0-5.64 p=0.04, Caesarean section (OR 1.98, 95%CI 1.24-3.14 p=0.003), postpartum haemorrhage (OR 8.57, 95%CI 1.07-76.15 p=0.04) and wound infection (OR 8.57, 95%CI 1.07-76.15 p=0.04) and adverse neonatal outcomes such as higher mean birth weight (p<0.0001) and requirement of NICU (OR 2.79, 95%CI 1.33 -5.84 p=0.006) was higher in obese women.Conclusions: Obesity is an independent risk factor for adverse pregnancy outcomes and hence, interventions directed towards weight loss and prevention of excessive weight gain must begin in the preconception period.
Pre labour rupture of membrane is associated with an increased maternal and perinatal morbidity and mortality. So confirmatory diagnosis is essential before initiating the definitive treatment of PROM.This study was a cross sectional, case control, hospital based study. All pregnant women having gestational age 28 to 42 weeks are divided into 3 groups as per criteria. Each group has 30 pregnant women group 1 and group 2 are the cases studied and group 3 is control group. Data analysis was done by ANOVA test, kurskal Wallis Test. Difference between two groups are analysed using Man whitney’s U test.The level of vaginal fluid urea and creatinine came out to be higher in group 1 (confirmed cases) than group 2 (suspected cases) and group 3 (controls).Detection of urea and creatinine in vaginal fluid is easy, safe and cost effective method to diagnose PROM.
BACKGROUNDUnplanned pregnancy is the reason behind majority of MTPs in a developing and overpopulated country like India. The unmet need for contraception still poses a challenge despite the best efforts of the Government and other Non-Government Organisations. So counselling regarding knowledge and use of contraception should be an integral part of post-abortion care. Only with counselling can the acceptance of contraceptive be increased in women of reproductive age. Thus, unwanted pregnancies and the risks involved due to unsafe abortion in many cases can be avoided.The aim of this study is to study the knowledge and awareness of contraceptives and assess their acceptability in women seeking medical termination of pregnancy (MTP) at two tertiary health centres in Bhubaneswar. MATERIALS AND METHODSA cross-sectional study of 257 women seeking MTP in two tertiary care hospitals in Bhubaneswar. Data regarding awareness of contraception and their acceptance in post-abortion period was collected using a pre-structured questionnaire. RESULTSMajority of women seeking MTP had two or more living children (68.1%) and were between 21 -30 years of age (64.2%). Most of them had prior knowledge of contraception excepting few (8.1%). Commonest reason for not using them was fear of side effects. All the women were counselled prior to discharge and most of them (89.2%) agreed to adapt birth control methods. CONCLUSIONUnmet need of contraception is the most common reason for women having unplanned pregnancy. Though the awareness of different methods of contraception is high, the actual acceptance rate is low. Hence, there is a need for community health education to inculcate proper knowledge and ensure their use in the target population.
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